South India Research Articles

Does a dedicated endocrine surgery unit impact treatment decision in patients with thyroid disorders? experiences from an endocrine-surgeon naive area in southern india

Does a dedicated endocrine surgery unit impact treatment decision in patients with thyroid disorders? experiences from an endocrine-surgeon naive area in southern india

Thinking with two heads: The poetics of asat in early-modern India

In early modern India, and particularly South India—from roughly the sixteenth century until the eighteenth—a new literary vogue emerged in all major literary traditions (Tamil, Telugu, Kannada, Malayalam, Sanskrit, Persian). With remarkable salience, we find verses built around absurdity of various kinds and modes. Sometimes it is a matter of pushing the existing literary conventions and figures to an impossible extreme. In other cases, we find a fascination with asymmetry, disjunction, skewed causality, and irrealis or counter-factual linguistic forms. Although such experiments with absurdity have precedents in classical kāvya, the evident consistency and intertextual relations among outlandish poems in this period are very striking, as is the fact that the theoreticians of poetics found it necessary to posit a grammar for them (including for poems based on asat, that is, non-existence or sheer impossibility). This essay explores the forms and logical underpinnings that this fashion for the bizarre assumed; we also offer a tentative explanation for the new trend. The prabandha-based poems of absurdity need to be distinguished from the coded texts known in Kannada as beḍagina vacana and in early Hindi as ulaṭbaṃsi, in which an upside-down or inside-out world is created, the goal being to arrest intellection altogether. We also show the distinction between the poetry of the absurd in the early modern texts and the European Dada movement, which aims at unravelling language and enshrines a principle of pure randomality in the choice of words.

A Review Paper on South Indian Startups and Firms - Issues, Challenges and Opportunities

An organization in its infancy is referred to as a startup. One or more entrepreneurs launch startups because they wish to provide a good or service that they think there is a market for. A startup is a recently established business that markets its goods and services using information and communication technologies (ICT). It has a scalable company plan where rapid and seamless growth is the main goal. A start up’s goals are to work for itself and for others, which necessitates some perseverance and atonement. Large population with high median income, educated youth with specialized training, it proficiency, high web, versatile entrance and many more are some of the factors that have opened doors for the expansion of startup transformation in India are adaptable entrance. In addition, the government's 'make-in-India' initiatives and other policies have stimulated the growth of new enterprises and drawn many individuals into the conflict.

Trend and interannual variability of summer marine heatwaves in the tropical Indian ocean: Patterns, mixed layer heat budget, and seasonal prediction

Marine heatwaves (MHWs) are extreme sea surface temperature (SST) events in all ocean basins, with far-reaching impacts on marine ecosystems and socio-economy. The leading patterns, trend, and interannual variability of summer MHWs in the tropical Indian Ocean (TIO) are investigated in this study. The first empirical orthogonal function (EOF) mode of frequency of MHWs exhibits a monopole pattern over the entire basin. This mode is highly associated with the concurrent Indian Ocean Basin warming, indicating a remarkable trend over the past four decades. The linear trend in MHW properties largely relates to increased summer Indian Ocean mean SST. The second EOF mode exhibits a zonal dipole with the MHW numbers increasing in the west and decreasing in the east. On the interannual timescale, the first two EOF modes are remotely affected by antecedent and concurrent El Niño events, respectively. The ocean mixed layer budget is utilized for examining the formation of different summer MHW patterns. During the preceding spring, the surface heat flux is important for the development of MHWs, while the ocean advections play a secondary role in the South Indian Ocean for the MHW monopole. Once the SST anomaly rises in summer, the ocean advections play a dominant role in maintaining the SST. Last, we assess the prediction skill of summer TIO MHWs by performing a bilinear seasonal statistical prediction model. Our results suggest the frequency of summer MHWs in the TIO could be predicted one season in advance. This study has great implications for understanding and predicting ocean extreme events in the TIO.

Detecting ‘green shoots’ of agri-food systems transformation: a framework and insights from the spread of non-pesticide approaches in South India

ABSTRACT System innovation is a signature feature of agri-food system transformation. Such system innovation often occurs in niches. However, how the "green shoots" of transformation can be detected and appraised through time remains ambiguous. This paper proposes, applies and tests a framework that could be used as a ‘transformation assessment tool’ to evaluate the level of system innovation in a domain of change. The framework is tested against a case study of a Non-Pesticide Management initiative in South India. The framework helps to reveal how, over 20 years, the initiative triggered a number of system innovations that opened a new development pathway, more aligned to environmental sustainability, equity and social inclusion. A critical enabling factor identified for the expansionand "blossoming" of this green shoot was its capacity to flexibly respond and adapt to emergent and largely unknowable agri-food systems dynamics. In its conclusions, the paper sheds light on the ongoing tensions around the defining benchmarks or thresholds for assessing the ‘transformativeness’ of initiatives and change processes. Finding a way of combining qualitative assessments of system changes with quantitative measures of social, economic, and environmental impact could be a valuable vein of research to enhance our understanding of transformative processes and how to enable them.

A ten-year experience of musculoskeletal tuberculosis at a tertiary care hospital in South India

BackgroundThe delayed identification and management of musculoskeletal tuberculosis (MSTB) poses substantial health challenges and leads to significant morbidity. This study aimed to collate ten years of hospital data and provide valuable insights into the clinical, diagnostics, and outcomes of the patients diagnosed with MSTB. MethodsA retrospective study was undertaken to review clinic records from 2013 to 2022 for all individuals diagnosed with MSTB in a tertiary care hospital in South India. ResultsOver a decade, 400 cases of MSTB were diagnosed, revealing 57 % males and 43 % females with a mean age of 43.2 ± 18.9 years. Spinal TB constituted 72 % of cases, with the most common involvement of thoracic vertebrae (50.9 %). Extra-spinal MSTB accounted for 28 %, prevalent more in the pediatric age group (p < 0.05). Surgical intervention was required for 80 % of spinal TB cases and 58 % of extra-spinal MSTB cases. The average follow-up duration was two years, with 73 % completing treatment. Unfortunately, seven patients died, and three experienced relapse. ConclusionSpinal TB is the most common type of MSTB and is predominant in young and middle-aged adults, while extra-spinal MSTB is more frequently observed in children. Where use of MRI facilitates early detection of spinal TB; histopathological and microbiological examination confirm the diagnosis. Combining anti-tubercular drugs with modern surgical approaches is essential for obtaining favorable outcomes and improving the quality of life of such patients. It is crucial to have advanced and affordable diagnostic facilities, along with increased public awareness, to reinforce tuberculosis control strategies.

A First Case Report of Talaromyces marneffei Infection in a Person with Immunocompromised Rheumatoid Arthritis and Non-HIV Diabetes in South India

A First Case Report of Talaromyces marneffei Infection in a Person with Immunocompromised Rheumatoid Arthritis and Non-HIV Diabetes in South India

The Moderating Effects of Gender and Age in the Relationship Between Job Insecurity and Turnover Intention During the Global Pandemic

This article explores the effect of perceived job insecurity on employees’ turnover intention during the global pandemic. A conceptual model was developed and tested with data collected from 398 faculty members in higher educational institutions in Southern India. After checking the instrument’s psychometric properties using structural equation modelling, the hypotheses were tested using hierarchical regression. The results indicate that three dimensions of job insecurity—the perceived threat to job features, the perceived threat to total job and the feeling of powerlessness—are positively associated with turnover intentions of faculty members. The results also reveal that age and gender moderated the relationship between (a) perceived threat to total job and turnover intention and (b) feeling of powerlessness and turnover intention. This study recommends that administrators not underestimate the perils of perceived job insecurity in terms of turnover intentions and steps need to be taken to ensure that employees feel safe and continue to work. This study highlights a simple fact: If adequate steps are not taken, crises like the global pandemic may adversely affect organisations.

Meat on and off the Royal Menu: The Medieval Delight of the Mind & the Erasure of Meat from Indian Recipe Collections

ABSTRACT A close study of the twelfth-century Delight of the Mind’s (Mānasollāsa’s) section on cooking called “The Enjoyment of Food” reveals that meat dominated the royal menu in medieval South India. The valuable recipes in this Sanskrit royal encyclopedia’s section of 258 verses on food detail primarily how to prepare wild fish and game, but also meat from tortoise, bandicoot, ram (mutton), other domesticated animals, and an array of delectable foods of the period. Consuming almost all animals that moved in the kingdom formed part of Western Chalukyan emperor Someśvara´s assertion of royal dominion, yet investigation into this recipe collection’s textual history as well as that of other royal recipe collections suggests that the once abundant meat recipes have often been removed from the record, leaving the false impression of more vegetarian dietary practice than really pertained to South Asia’s past. This later “veggie-washing” concerns Hindu ideologies of nonviolence and the disavowal of animal slaughter in ritual sacrifice, both of which originated in Jain and Buddhist ideologies yet have become attached to Hindu ideals of vegetarianism, forming part of a new moral culinary imperative that has advanced over roughly the second millennium of the Common Era. Exploring this topic using the lens of power and politics as they relate to food and dining allows the reader to observe shifts in royal culinary writing as these texts became permeated with religious ideals.

Association of sleep quality with physical and psychological health indicators in overweight and obese rural Indians

ObjectiveTo measure the association of sleep quality with physical (i.e., grip strength, functional mobility, balance) and psychological (depression, anxiety) health indicators in an overweight/obese population. MethodsBaseline data of 2337 participants (1382 overweight/obese and 955 normal weight) from an aging cohort in rural southern India (CBR-SANSCOG) was analyzed retrospectively. Assessment tools included the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, dynamometry for Hand Grip Strength (HGS), Timed Up-and-Go (TUG) for functional mobility, Chair Stand Test (CST) for lower limb strength, Geriatric Depression scale (GDS-30) for depressive symptoms and Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms. Linear regression models, adjusted for known confounders, were used to examine the association of sleep quality with the health parameters in overweight/obese and normal-weight groups. ResultsIn the fully adjusted model, higher global PSQI score was associated with higher TUG time (β = 0.06, 95 % CI: 0.004,0.12), higher scores on GDS (β = 1.08, 95 % CI: 0.96,1.20) and GAD (β = 0.71, 95 % CI: 0.62,0.79), and lower scores on CST (β = -0.12, 95 % CI: -0.19,-0.06) in overweight/obese individuals. The sleep disturbance sub-component of PSQI was associated with most of the physical (TUG, CST) and psychological (GDS and GAD) health indicators. Sleep duration and use of sleep medication showed no significant association with any of the health indicators. ConclusionThe concurrent presence of poor sleep quality and overweight/obesity could worsen physical and psychological health in middle-aged and older adults. We highlight the importance of early detection and timely management of sleep problems in this population to reduce physical and psychological morbidities.

Social capital of families of children with neurodevelopmental disabilities in South India.

To investigate the social capital of families with children with neurodevelopmental disabilities in South India receiving a community-based early intervention (Enabling Inclusion®) program and to explore determinants and associations between social capital and program duration, socio-demographic factors, family empowerment, and caregiver burden. Using purposive sampling in a cross-sectional study design, 217 families (n = 71 received short Enabling Inclusion [<5 months]; n = 146 received long Enabling Inclusion [>9 months]) were recruited and completed the Short Adapted Social Capital Tool (SASCAT: cognitive, structural), measures of family empowerment, and caregiver strain. Descriptive statistics, regression, and correlations were used for analyses. In 52.1% of participants, low cognitive and structural social capital was observed. Higher odds of low structural social capital were observed for mothers with primary versus secondary education (adjusted odds ratio [OR] = 0.35; 95% confidence interval [CI] 0.13-0.90; p = 0.029); and caregivers of children with cerebral palsy versus autism (OR = 4.66; 95% CI 1.02-21.21; p = 0.046). Significant associations were found between structural social capital, the child's age, and support group membership (χ2 = 6.29; 4.70; degrees of freedom [df] = 2; 1; p = 0.04; p = 0.02 respectively), as well as between cognitive social capital and other disability in the family (χ2 = 4.62, df = 1, p = 0.03). While program duration was not found to mediate social capital, mother's education and child's diagnosis emerged as key influential factors, warranting their consideration in interventions supporting families of children with neurodevelopmental disabilities in low- and-middle-income countries and elsewhere.

Immune profiling reveals umbilical cord blood mononuclear cells from South India display an IL-8 dominant, CXCL-10 deficient polyfunctional monocyte response to pathogen-associated molecular patterns (PAMPs) that is distinct from adult blood cells.

Neonate responses to pathogen-associated molecular patterns (PAMPS) differ from adults; such understanding is poor in Indian neonates, despite recognised significant infectious risk. Immune profiling analysis was undertaken of ten secreted mediators contextualised with cellular source induced by six PAMPs in umbilical cord (CB; n=21) and adult-blood (PBMC, n=14) from a tertiary care hospital in South India. Differential cytokine expression analysis (minimum log2-fold difference; adj p-value<0.05) identified bacterial PAMPs induced higher concentrations of IL-1β, IL-10, TNF-α in adults versus IL-8, GM-CSF, IFN-γ and IL-2 in CB. CB responded to poly I:C and SARS-CoV-2 lysate with a dominant IL-8 response, whereas, in PBMC, CXCL-10 dominated poly I:C, but not SARS-CoV-2, responses, highlighting potential IL-8 importance, in absence of Type I Interferons, in antiviral CB immunity. Candida albicans was the only PAMP to uniformly induce higher secretion of effectors in CB. The predominant source of IL-8/IL-6/TNF-α/IL-1β in both CB and PBMC was polyfunctional monocytes and IFN-γ /IL-2/IL-17 from innate lymphocytes. Correlation matrix analyses revealed IL-8 to be the most differentially regulated, correlating positively in CB versus negatively in PBMC with IL-6, GM-CSF, IFN-γ, IL-2, consistent with more negatively regulated cytokine modules in adults, potentially linked to higher anti-inflammatory IL-10. Cord and adult blood from India respond robustly to PAMPs with unique effector combinations. These data provide a strong foundation to monitor, explore, mechanisms that regulate such immunity during the life course, an area of significant global health importance given infection-related infant mortality incidence.

Comparison of treatment adherence among TB patients with and without COVID-19 in South India

AimThe present study aimed to compare the adherence to anti-TB treatment among post-COVID-19 pulmonary TB cases and TB patients without a history of COVID-19 in South India. MethodsA prospective, cross sectional study was conducted in all drug-sensitive pulmonary tuberculosis patients in National TB Elimination Program. The research investigates the impact of the COVID-19 pandemic on TB management, considering both subjective and objective measures of adherence. Data were collected using a validated instrument for subjective assessment and urine metabolite testing for objective evaluation. ResultsThe results reveal significant differences (p < 0.05) between subjective and objective adherence measures, emphasizing the need for accurate and comprehensive assessment methods. However, there is no statistically significant difference (p > 0.05) in adherence to anti-TB treatment among post-COVID-19 pulmonary TB cases and TB patients without a history of COVID-19 in South India. The reason for non-adherence in both groups were ATT side effects, loss of daily wages, forgetting to take medication and lazy to take medications. ConclusionThe study concluded that there is no statistically significant difference (p > 0.05) in adherence to anti-TB treatment among post-COVID-19 pulmonary TB cases and TB patients without a history of COVID-19.

Sex-based differences in TB treatment compliance: A mediating factor for sputum conversion among newly diagnosed pulmonary TB patients in Chennai, South India

BackgroundTuberculosis (TB) remains a global health concern, particularly in India, which carries a significant portion of the global burden. The role of sex as a determinant of health is increasingly recognized, impacting various aspects of TB, including treatment compliance and outcomes. This study aimed to determine the mediating role of treatment compliance in the relationship between sex and sputum conversion in newly diagnosed pulmonary TB patients in Chennai, South India. MethodsWe conducted a retrospective cohort study among patients newly diagnosed for TB at ESIC Medical College & PGIMSR between April 2020 and April 2022. A causal mediation analysis was performed to identify the direct and indirect effects of sex on sputum conversion via the mediator, treatment compliance. We employed logistic regression models and the “paramed” package for the analysis, with bootstrapping technique for examining the significance of indirect and direct effects. ResultsThe Marginal Total Effect (MTE) suggested that females were more likely to have sputum positivity compared to males (OR: 6.77; p = 0.003). Direct effect of being female increased the odds of sputum positivity at the end of the intensive phase (OR: 3.42; p = 0.03). The indirect effect of being female via treatment compliance significantly increased the odds of sputum positivity at the end of the intensive phase (OR: 1.98; p = 0.03). ConclusionThe study provides evidence that treatment compliance significantly mediates the relationship between sex and sputum conversion in TB patients, highlighting the necessity to consider gendered dimensions of health in TB control strategies.

Diagnostic markers of acute encephalitis syndrome and COVID-associated multisystem inflammatory syndrome in children from Southern India.

Acute encephalitis syndrome (AES) in children poses a significant public health challenge in India. This study aims to explore the utility of host inflammatory mediators and neurofilament (NfL) levels in distinguishing etiologies, assessing disease severity, and predicting outcomes in AES. We assessed 12 mediators in serum (n = 58) and 11 in cerebrospinal fluid (CSF) (n = 42) from 62 children with AES due to scrub typhus, viral etiologies, and COVID-associated multisystem inflammatory syndrome (MIS-C) in Southern India. Additionally, NfL levels in serum (n = 20) and CSF (n = 18) were examined. Clinical data, including Glasgow coma scale (GCS) and Liverpool outcome scores, were recorded. Examining serum and CSF markers in the three AES etiology groups revealed notable distinctions, with scrub typhus differing significantly from viral and MIS-C causes. Viral causes had elevated serum CCL11 and CCL2 compared with scrub typhus, while MIS-C cases showed higher HGF levels than scrub typhus. However, CSF analysis showed a distinct pattern with the scrub typhus group exhibiting elevated levels of IL-1RA, IL-1β, and TNF compared with MIS-C, and lower CCL2 levels compared with the viral group. Modeling the characteristic features, we identified that age ≥3 years with serum CCL11 < 180 pg/mL effectively distinguished scrub typhus from other AES causes. Elevated serum CCL11, HGF, and IL-6:IL-10 ratio were associated with poor outcomes (p = 0.038, 0.005, 0.02). Positive CSF and serum NfL correlation, and negative GCS and serum NfL correlation were observed. Median NfL levels were higher in children with abnormal admission GCS and poor outcomes. Measuring immune mediators and brain injury markers in AES provides valuable diagnostic insights, with the potential to facilitate rapid diagnosis and prognosis. The correlation between CSF and serum NfL, along with distinctive serum cytokine profiles across various etiologies, indicates the adequacy of blood samples alone for assessment and monitoring. The association of elevated levels of CCL11, HGF, and an increased IL-6:IL-10 ratio with adverse outcomes suggests promising avenues for therapeutic exploration, warranting further investigation.

Paleoarchean sedimentation and Mesoarchean high-temperature metamorphism in northeastern Brazil: Tracing sources and depositional ages in polymetamorphic rocks

Supracrustal rocks offer a window into tectonic processes of the early Earth, since they are common in the Archean lithosphere. However, these rocks are usually affected by several episodes of metamorphism that can compromise their UPb systematics, leading to equivocal interpretations of depositional ages and sources. In northeast Brazil, supracrustal rocks are frequent within the Archean basement of the São José do Campestre Massif. These metapelitic migmatites show a high-temperature mineral assemblage, with garnet + sillimanite ± spinel and retrograde cordierite, with abundant anatectic melt migration at conditions of upper amphibolite to granulite facies. Zircon UPb dating coupled to trace elements analysis through LA-ICP-MS, as well as zircon internal zoning patterns suggest a maximum depositional age of 3305 ± 16 Ma followed by high-temperature metamorphism in the Mesoarchean, Paleoproterozoic and Neoproterozoic. Mesoarchean high temperature metamorphism occurred between 3084 ± 4 and 3006 ± 6 Ma and generated a wide range of textures that could be grouped in, at least, three stages of zircon growth. The first, during prograde heating, led to dissolution of detrital cores through the process of Ostwald Ripening and reprecipitation in oscillatory zoned rims. The second, probably at peak conditions, occurred above the stability of monazite, as evidenced by high Th/U ratios within zircon grains, rounded shape and sector-zoned cores. The third, during retrograde cooling, is mostly driven by garnet breakdown, and resulted in the crystallization of convoluted rims. Ti-in-zircon temperatures indicate minimum temperatures of 712 ± 21 °C for prograde/retrograde stages and 881 ± 50 °C for peak conditions. The Paleoarchean sedimentation and Mesoarchean metamorphism are coeval with similar events in Kaapvaal and Dharwar Cratons (South Africa and South India, respectively), but show no correlation to any Archean domains in South America to date. Solid-state recrystallization during the Paleoproterozoic (ca. 2.0 Ga) and the Neoproterozoic (ca. 0.6 Ga) correlates with orogenic events in both the Borborema Province and São Francisco Craton, suggesting a common evolution since the Rhyacian.

Deep anterior lamellar keratoplasty in advanced keratoconus in children: A 4-year study

Purpose: The purpose of the study was to evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) in children and adolescents with advanced keratoconus (KC) at a tertiary eye care center in India. Design: This was a retrospective cross-sectional study. Methods: All cases of KC under the age group of 18 years, operated for DALK at a tertiary eye care center in South India, were evaluated from January 2018 to January 2022; outcome measures were best-corrected visual acuity (BCVA), graft clarity at final follow-up, and complications. Results: Of 27 eyes of 25 cases, 16 were male and 9 were female, with a mean age of presentation at 14.9 years. In stromal dissection technique, big bubble was attempted in 23 eyes and achieved in 20 eyes; manual dissection was done for the rest of the cases. Final BCVA varied from 0.1 to 0.6 logMAR units. Twenty-three eyes had excellent graft clarity at final follow-up. Complications noted in the study were intraoperative microperforation in four cases, postoperatively suture-related complications in three cases, and corneal graft rejection in one case. Conclusion: DALK in pediatric age group for advanced KC is an effective treatment option.

Clinicoetiological profile of congenital cataracts in children: A single-center experience

Introduction: Congenital cataract is the most common treatable cause of blindness during infancy and is responsible for 5%–20% of blindness in children worldwide. Materials and Methods: It was a retrospective descriptive study analyzing the causes of congenital cataracts in infants referred to the pediatric neurology department of a tertiary care institution, in South India. Results: Thirty-two infants with congenital cataracts underwent evaluation. Thirteen (40.6%) were &lt;6 months and 19 (59.4%) beyond 6 months of age. White reflex in eyes was the primary complaint in 14 (43.8%), not looking at the caregiver in 10 (31.3%), squint in 5 (15.6%), and involuntary movement of eyeballs in 3 (9.4%) patients. Cataracts were bilateral in 26 (81.3%) and unilateral in 6 (18.7%) patients. The associated features were developmental delay in 25 (78.1%), microcephaly in 15 (46.9%), seizures in 6 (18.8%), cardiac disease in 6 (18.8%), focal deficit in 3 (9.4%), and deafness in 2 (6.3%). Neuroimaging revealed basal ganglia calcifications in 6 (18.7%), cerebral atrophy in 3 (9.4%), gliosis in parieto-occipital regions and hyperintensities in frontal regions in 2 (6.3%) children each, and hydrocephalus, Dandy–Walker malformation, thin corpus callosum, and hypomyelination in one (3.1%) each. The etiological causes were confirmed rubella syndrome in 7 (21.9%), probable rubella syndrome in 3 (9.4%), confirmed cytomegalovirus in 6 (18.8%), probable cytomegalovirus in 7 (21.9%), herpes virus infection in 1 (3.1%), combined infections in 2 (6.3%), Down syndrome in 3 (9.4%), Lowe syndrome in 1 (3.1%), and idiopathic in 2 (6.3%) patients. Conclusion: Intrauterine infections, especially cytomegaloviral and rubella infections, are the common causes for congenital cataracts in infants. Vaccination against rubella, knowledge about intrauterine infections, mode of spread, and prevention are the needs of the hour.

An assessment of anticipated future changes in water erosion dynamics under climate and land use change scenarios in South Asia

Water erosion has emerged as a significant global environmental challenge, particularly in South Asia, recognized as one of the regions hardest to hit globally by climate change. This study aims to identify the potential erosion hotspots in South Asia and to assess areas under risk in the future due to climate and land use change scenarios. We utilized the Revised Universal Soil Loss Equation (RUSLE), an empirical erosion model, to estimate erosion for both historical and future periods, considering two distinct Shared Socio-economic Pathways (SSP126 and SSP585). The baseline model predicts a mean water erosion rate of 10.6 t. ha−1. year−1 in South Asia, with more than 30 t. ha−1. year−1 recorded for 6.3 % of the total land area. Notably, Bangladesh and Nepal exhibit significantly higher erosion rates than other South Asian countries. Further, our projection indicates an + 10 % increase in erosion rates during the near future (2021–2040) under SSP585 compared to the historical estimates. A substantial rise of approximately + 31 % and + 39 % in water erosion rates in South Asia is anticipated during the far future periods of 2061–2080 and 2081–2100 under SSP585. At the country level, Bangladesh (+42 %), Bhutan (+108 %), and Nepal (+70 %) are expected to experience substantial increases in erosion rates during the 2081–2100 period, with India projecting a + 38 % increase. Additionally, a significant + 35 % expansion in the spatial extent of high erosion areas (>30 t. ha−1. year−1) is foreseen in 2081–2100 under SSP585. Furthermore, under the low climate change scenario (SSP126), the impact on the erosion rates is minimal, while under SSP585, a substantial increase in erosion rates is anticipated. Regions such as south India, the arid and semi-arid areas near the India-Pakistan border, and the Himalayan foothills are identified as hotspots for significant changes in erosion rates. Acknowledging a certain level of uncertainty, our study provides valuable insights into erosion risk areas in South Asia and their plausible future impacts due to climate and land use changes. This information can assist policymakers in South Asian countries in developing national-level strategies for soil conservation and climate resilience.

Exploring misclassification of injury intent: A burn register study

IntroductionBurn registers are an important source of surveillance data on injury intent. These data are considered essential to inform prevention activities. In South Asia, intentional burn injuries are thought to disproportionately affect women. Assessment of injury intent is difficult because it is influenced by personal, family, social, and legal sensitivities. This can introduce misclassification into data, and bias analyses. We conducted a descriptive, hypothesis generating study to explore misclassification of injury intent using data from a newly digitised single centre burn register in south India. MethodsData from 1st February 2016 to 28th February 2022 were analysed. All patients in the data set were included in the study (n = 1930). Demographic and clinical characteristics for patients are described for each classification of injury intent. All data cleaning and analyses were completed using RStudio. ResultsInjury intent data were missing for 12.6% of cases. It was the most commonly missing variable in the data set. “Accidental” injuries had a similar distribution over time, age, and total body surface area (TBSA) for males and females. “Homicidal” injuries were more common in females. Injuries reported as “Suicidal” affected men and women equally. A decrease in reporting of “Suicidal” injuries in females corresponded to an increase in high TBSA injuries classified as ‘Other’ or with missing data. Overwriting of injury intent was present in 1.5% of cases. The overwritten group had a greater proportion of females (62.1% vs. 48.5%) and higher median TBSA (77.5% vs. 27.5%) compared to the group where intent was not overwritten. ConclusionOur findings indicate that some subgroups, such as females with high TBSA burns, appear to be more likely to be misclassified and should be the focus of future research. They also highlight that quality of surveillance data could be improved by recording of clinical impression, change in patient reported intent, and use of a common data element for intent to standardise data collection. We also recommend that injury intent is recorded as a unique variable and should not be mixed with other elements of injury causation (e.g. mechanism). Although this is a single centre study, the methods will be of interest to those who utilise routinely collected data and wish to reduce misclassification of this important variable.